Non-intervention is successful in 93% of cases of umbilical herniae. For asymptomatic patients, reassurance may be all that is necessary. A high percentage of cases will resolve spontaneously within the first few months of life. The healing process may be hastened by pulling the skin and abdominal musculature together using adhesive strapping placed across the abdomen.
Surgery should not be performed before the age of 2 years. The herniorrhaphy is performed by making a small curved incision immediately below the umbilicus. The skin cicatrix is dissected upwards and the neck of the sac isolated. After emptying the sac, it is inverted into the abdomen or ligated by transfixion and excision. The defect in the linea alba is closed with two unabsorbable sutures.
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